Esophageal cancer is one of the deadliest cancers worldwide. Because of it's location and lack of symptoms until the disease has significantly progressed, esophageal cancer generally has a poor prognosis. Esophageal cancer is found in two main subsets, adenocarcinoma and squamous cell cancer. Adenocarcinoma is the most common esophageal cancer in the United States, but squamous cell cancer is much more prevalent worldwide and accounts for nearly 95% of global cases of esophageal cancer.
Esophageal cancer is cancer of the esophagus, which is the hollow, connecting tube between the mouth and stomach. Changes in the DNA of the cells that line the esophagus cause the cells to replicate uncontrollably and create tumors that cause damage and make eating difficult. Drinking alcohol, smoking tobacco, having frequent acid reflux, and exposure to the HPV (Human papillomavirus) increases risk of esophageal cancer. Men and people over the age of 40 are more likely to get esophageal cancer, as are people with Asian or African ancestry. Eating a diet high in fruits and vegetables and a moderate coffee consumption may reduce the risk of this disease.
Esophageal cancer does not generally cause symptoms until the disease has progressed, this is the reason for the poor prognosis in many patients. The first symptoms of this cancer are difficulty or painful swallowing, often caused by tumors partially blocking the esophagus. In advanced cases, difficulty breathing can be caused by tumors pressing on the trachea. Diagnostic tests are used, such as biopsy, when a tumor is located to identify the type of cancer, however generally tumors found in the upper 2/3's of the esophagus are squamous cell carcinoma and tumors found in the lower 1/3 are adenocarcinoma. Adenocarcinoma has been closely linked to acid reflux and the high rates of this disease in the United States are likely related to American dietary habits.
Surgery is commonly used to remove small tumors in the esophagus. Advanced cases and large tumors cannot be removed by surgical methods and radiation and chemotherapy are used to slow the prognosis of the disease or shrink the tumor(s) enough to allow for surgical removal. Laser therapy is used in a small percentage of cases, generally cases that are too advanced for surgical removal. The survival rate of esophageal cancer is considered very poor, the majority of esophageal cancer patients die within the first year and the five year survival rate is only 15%.